RT Journal Article SR Electronic T1 Direct Iliac Screw vs Sacral-2-Alar-Iliac Screws Technique for Sacropelvic Fixation: Technical Nuances and a Review of the Literature JF International Journal of Spine Surgery JO Int J Spine Surg FD International Society for the Advancement of Spine Surgery SP 8449 DO 10.14444/8449 A1 Ahmed Habib A1 Nallammai Muthiah A1 Ali Alattar A1 Meagan Hoppe A1 Nitin Agarwal A1 Nima Alan A1 David Kojo Hamilton A1 Alp Ozpinar YR 2023 UL http://ijssurgery.com//content/early/2023/04/13/8449.abstract AB Sacropelvic (SP) fixation is the immobilization of the sacroiliac joint to attain lumbosacral fusion and prevent distal spinal junctional failure. SP fixation is indicated in numerous spinal conditions (eg, scoliosis, multilevel spondylolisthesis, spinal/sacral trauma, tumors, or infections). Many SP fixation techniques have been described in the literature. Currently, the most used surgical techniques for SP fixation are direct iliac screws and sacral-2-alar-iliac screws. There is currently no consensus in the literature on which technique carries more favorable clinical outcomes. In this review, we aim to assess the available data on each technique and discuss their respective advantages and disadvantages. We will also present our experience with a modification of direct iliac screws using a subcrestal approach and outline the future prospects of SP fixation.